Entamoeba polecki infection in Southeast Asian refugees: multiple cases of a rarely reported parasite

Recently, Entamoeba polecki was identified for the first time in our parasitology laboratory in stool specimens from eight Southeast Asian refugees. This ameba has been reported infrequently in the Western world; most reported cases have been from the New Guinea region. In most previously described patients and in our patients, no definite gastrointestinal symptoms could be directly attributed to E. polecki infection. Morphologically, E. polecki may mimic the pathogen E. histolytica and also nonpathogens such as E. coli. These species are most readily distinguished by studying encysted forms. In contrast to E. histolytica and E. coli, E. polecki characteristically has uninucleate cysts. Both pigs and monkeys naturally harbor E. polecki, but four of the patients in this series had no apparent contact with these animals. Other modes of infection may be human-to-human transmission or acquisition from other domestic animals. Six of our eight patients were treated successfully with one course of metronidazole in a regimen similar to that used for E. histolytica infection. In the two other patients, repeated courses of therapy eradicated the infection. Because of the recent increase in number of Southeast Asian immigrants to the United States, E. polecki may be identified more frequently than in the past. Physicians and laboratory personnel should be familiar with this organism, because it may be confused with E. histolytica or may act as a pathogen.     

Minimal surgical debridement for the treatment of chemotherapeutic agent-induced skin extravasations

A rat model was employed to determine the efficacy of early minimal debridement in decreasing the size of chemotherapeutic agent-induced skin ulcers. After receiving bilateral flank injections of doxorubicin in a concentration comparable to that received by humans, the right injection site underwent minimal debridement 1, 24, or 72 hours after the injection. The left side of each animal was not operated upon and served as a control. Three subgroups of the 1-, 24-, and 72-hour debridement groups were treated as previously described, except that any residual necrotic tissue was debrided 1 week after the original debridement. All minimal debridement and redebridement groups produced significant decreases in ulcer size compared to controls. Comparing minimal debridement and redebridement groups to controls, it was found that surgery produced reductions in the number of persistent ulcers in all groups. Minimal debridement followed by redebridement was significantly more effective than minimal debridement alone in decreasing ulcer size acutely. One case is presented in which an extravasation of dactinomycin was treated by early minimal debridement. The patient had an uncomplicated postoperative course, and at follow-up 21 months after surgery had excellent functional and cosmetic results. Based upon animal studies and human experience, early surgical debridement appears to be a promising new method for the treatment of clinically significant vesicant extravasations in humans.     

Treatment methods for extravasations of chemotherapeutic agents: a comparative study

A rat model was used to compare early surgical intervention with injectable and topical antidotes with regard to their effectiveness in preventing cutaneous ulcers that were caused by intradermal injections of vesicant chemotherapeutic agents. The (animals) rats received bilateral flank injections of doxorubicin, vincristine, actinomycin D, mitomycin C, or carmustine (BCNU) in concentrations that were comparable to concentrations used for human patients; after the injections they underwent debridement at various intervals or received immediate applications of selected antidotes. Many "antidotes" which were frequently used, were not effective in limiting the size of the ulcer and in producing rapid healing of ulcers that were caused by experimental vesicant extravasations. Early surgical debridement was the most effective method of decreasing vesicant ulcer size and facilitating rapid ulcer healing of all the interventions tested.     

Lipid Levels in Refugees from Burma

Journal of Community Health - Cardiovascular risk is common among resettled refugees from Southeast Asia, but the association with refugee status is unclear. This study investigated the lipid...     

Quantitative assessment of human cochlear function by evoked otoacoustic emissions

The amplitudes of evoked otoacoustic emissions (EOE) and their detection threshold were measured in 44 normal young adults and 118 patients with two categories of cochlear dysfunction, acoustic trauma and presbycusis. A different method was used for each category: detection of click EOE or of stimulus frequency emissions. A partial correlation and multivariate analysis was performed for both groups of results to investigate the relations between EOE threshold one pure tone audiometric thresholds (250 to 8000 Hz). Only one significant correlation was found, linearly relating EOE threshold and hearing threshold at 2 kHz (P less than 0.001), independently of the origin of cochlear dysfunction. It suggests that EOE threshold is not frequency-specific since the frequency of EOE at threshold was nearly always close to 1 kHz. A simple model is proposed, based on the assumption that EOE amplitudes and threshold are proportional to the total number of residual active sites in the organ of Corti, i.e. to the total length of active basilar membrane. It is shown that this model accounts for the results disclosed by the statistical analysis and fits the experimental data. It can be used for quantitatively predicting the residual cochlear activity of a patient. However, the EOE threshold is only sensitive to already important cochlear alterations and this parameter does not seem to allow a follow-up of early stages of cochlear dysfunction.     

Staff Training Interests,Barriers, and Preferences in Rural and Urban Child Care Programs in Minnesota

Objectives

To describe any rural–urban differences in child care providers’ (1) past training on the facilitation of child healthy eating and physical activity and (2) views relevant to the design of trainings.

Identification of the novel allele Cw*040110 in a German patient

We report here the identification of a novel human leukocyte-Cw*040110 allele detected by polymerase chain reaction sequence-based typing in a German patient.     

Individual nuclear uptake patterns for adriamycin and daunomycin in human leukemia and lymphoma cells

Summary Since both cytotoxicity and resistance towards the anthracycline derivatives adriamycin and daunomycin have been related to cellular uptake and intranuclear retention, the nuclear concentrations of these antibiotics were separately determined in various human leukemia cells after standardised in-vitro exposure. The study included analyses of cells from 31 patients (AML, 12; AUL, 7; T-cell leukemias, 4; leukemic B-cell lymphomas, 2; CML blast crisis, 5; CLL, 1). In all samples studied the uptake was concentrative with intranuclear concentrations exceeding the concentrations in the medium by factors of 4-10 for adriamycin and 6-13 for daunomycin. After 90 min of incubation, when daunomycin incorporation had reached steady state and 90% of the steady state concentrations was reached in the case of adriamycin, the comparative nuclear anthracycline concentrations showed a marked patient-to-patient variation without any relation to the cytological or cytochemical classification. Striking differences were noted in the ratios of DNM/ADM intranuclear concentrations ranging from 1.0 to 5.5. The DNM/ADM ratio was low in three cases with prior DNM treatment and, vice versa, increased in a case of CML blast crisis from 1.8 to 2.7 following ADM treatment.These results suggest that the processes involved in cellular uptake and intranuclear concentration of the two conventional anthracyclines may be different.Although more detailed analyses will be necessary the data could explain the clinical observation that in the chemotherapy of human leukemias daunomycin and adriamycin do not behave fully cross-resistant.Supported by Deutsche Forschungsgemeinschaft, SFB No. 102, Project C2